Almost 3 million U.S. military veterans live in rural communities and rely on the Veterans Administration for health care. In fact, the VA allocates 32 percent of its health care budget to rural veteran care. These are well known facts. Less well known are the facts surrounding service members discharged for misconduct, many of whom return or retire to rural America without the benefits available to veterans who were honorably discharged.

According to the Government Office of Accountability (GAO), 13,283 or 23% of service members discharged for misconduct between 2011 and 2015 were diagnosed with Post-Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI) or another mental health condition, and some members of the Navy were separated in lieu of a court martial in direct violation of Pentagon policy which requires a medical exam. Navy policy does not require a medical exam for this type of discharge.

If you are familiar with the movie Pirates of the Caribbean: Curse of the Black Pearl, there is a scene in which Barbossa, an 18th century pirate, discusses ship policy. Barbossa tells his unwilling guest Miss Turner, “First, your return to shore was not part of our negotiations nor our agreement, so I must do nothing. And secondly, you must be a pirate for the pirate’s code to apply, and you’re not. And thirdly, the code is more what you’d call “guidelines” than actual rules.”

Some things never change, it seems.

In a document that was published in May 2017 (DOD Health: Actions Needed to Ensure Post-Traumatic Stress Disorder and Traumatic Brain Injury Are Considered in Misconduct Separations), the Government Office of Accountability (GAO) expresses concern about the lack of consistency in the policies between each branch of the military. The GAO is an auditory and investigative office with very little ability to enforce changes in government organizations, but they have made several recommendations to the DOD.  One of the recommendations was to address inconsistencies in discharge training policies. The GAO found that “two of the four military services have TBI training policies that are inconsistent with DOD policy.” The DOD declined to address the inconsistencies, however.

Another area of concern for the GAO is the lack of data or the inadequate use of the data to monitor adherence to policies related to PTSD and TBI services that are provided. Failure to monitor the adherence to these policies may result in service members being inappropriately separated for misconduct, the GAO noted.

To date, the Department of Defense has failed to provide consistent guidance in addressing TBI, PTSD, and other mental health disorders that may lead to misconduct discharges. The Pentagon must develop a consistent training program and a single policy that is required for all branches of the military to use, monitor, and enforce to protect service members that are subject to other than honorable discharges.

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Ronald Martin is a Licensed Professional Counselor-Supervisor in Texas. He currently works at the Texas Tech University Health Sciences Center in Lubbock with the TWITR project providing mental health assistance to adolescents in rural schools. He also provides mental health assessments in local emergency rooms. Ron retired from law enforcement after thirty-seven years. He retired as a Chief and National Chaplain from the Department of Homeland Security, Office of Field Operations, El Paso, Texas in 2013. During the course of his career he served as an instructor and course developer for the National Chaplain Academy presented at the Federal Law Enforcement Training Centers in Artesia, NM and Glynco, GA.